Organization
METROPOLITAN ANESTHESIA NETWORK, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL C MCCORMICK MD (PRESIDENT)
(763) 559-3779
Entity
Organization
Contact information
Practice address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204512500
—
MN
Enumeration date
05/19/2006
Last updated
02/09/2016
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